硬膜外微创介入术治疗颈椎间盘突出症

THE TREATMENT OF CERVICAL DISC HERNIATION BY EPIDURAL MINMAL-INVASIVE INTERVENTIONAL THERAPY

目的 :应用硬膜外微创介入术治疗 4 7例颈椎间盘突出症患者。方法 :患者分为两组 ,第 1组采用影像引导下硬膜外植入导管连续注药术 ,第 2组采用影像引导下硬膜外植入导管连续给药术和胶原酶溶解术 ,对照观察治疗前、治疗后 14、30、6 0和 90天的疼痛视觉模拟评分 (VAS)和皮肤触觉评分。结果 :治疗后患者疼痛均明显减轻 ;治疗后 6 0天和 90天 ,第 2组VAS评分明显低于第 1组。两组治疗后触觉评分显著高于治疗前值 ,第 2组治疗后各时间触觉评分均显著高于第 1组。结论 :影像引导下硬膜外植入导管连续注药术和胶原酶溶解术联合应用 ,治疗颈椎间盘突出症的疗效优于单纯硬膜外植入导管连续注药术。

Objective: 47 patients with cervical disc herniation were treated by epidural minimal invasive interventional therapy. Methods: Patients were divided into two groups. Epidural catheters were inserted under the guide of X-ray scan and epidural continuous infusions were given in the first group. Both epidural continuous infusions and cervical discolysis with collagenase were given in the second group. VAS pain scores and skin touch perception scores were recorded and compared before treatment vs 14,30,60,and 90 days after treatment in both groups. Results: The cervicogenic pain was alleviated in all patients in both groups after treatment. VAS pain scores in the second group were significantly lower than those in the first group 60 and 90 days after treatment ( P <0.05). Skin touch perception scores in the second group were significantly higher than those in the first group 14,30,60 and 90 days after treatment. Conclusion: The therapeutic effects of combinated epidural continuous infusion and cervical discolysis with collagenase are much better than the epidural continuous infusions only for the treatment of cervical disc herniation.